JP5951622B2 - Surgical instrument shaft with a resiliently biased connection to the handpiece - Google Patents

Description

(priority)
This application claims priority to US Provisional Patent Application No. 61 / 410,603, entitled “Energy-Based Surgical Instruments”, filed Nov. 5, 2010, the disclosure of which is herein incorporated by reference. Incorporated by reference.

  This application also claims priority to US Provisional Patent Application No. 61 / 487,846, entitled “Energy-Based Surgical Instruments”, filed May 19, 2011, the disclosure of which is hereby incorporated herein by reference. Incorporated by reference in the book.

  This application also claims priority to US non-provisional patent application No. 13 / 271,364 filed October 12, 2011, entitled “SURGICAL INSTRUMENT SHAFTH WITH RESILIENTLY BIASSED COUPLING TO HANDPIECE”. The disclosure is incorporated herein by reference.

  In some situations, endoscopic surgical instruments may be preferred over conventional open surgical devices because smaller incisions often tend to reduce post-surgical recovery time and complications. Accordingly, some endoscopic surgical instruments may be suitable for placing a distal end effector at a desired surgical site via a trocar cannula. These distal end effectors can engage tissue in a number of ways to achieve a diagnostic or therapeutic effect (eg, end cutters, graspers, cutters, staplers, clip appliers, access devices, drug / gene therapy) Delivery devices and energy delivery devices using ultrasound, RF, lasers, etc.). An endoscopic surgical instrument may have a shaft operated by a clinician between the end effector and the handle portion. Such a shaft allows for insertion to a desired depth and rotation about the longitudinal axis of the shaft, thereby facilitating positioning of the end effector within the patient.

  An example of an endoscopic surgical instrument is US Patent Publication No. 2006/0079874 entitled “Tissue Pad Use with an Ultrasonic Surgical Instrument” published April 13, 2006, the disclosure of which is incorporated herein by reference. No. 2007/0191713 entitled “Ultrasonic Device for Cutting and Coagulating” published on August 16, 2007, the disclosure of which is incorporated herein by reference, the disclosure of which is incorporated herein by reference US Patent Publication No. 2007/0282333 entitled “Ultrasonic Waveguide and Blade” published on Dec. 6, 2007, the disclosure of which is hereby incorporated by reference. US Patent Publication No. 2008/0200940 entitled “Ultrasonic Device for Cutting and Coagulating” published on August 21, 2008, published on Jan. 20, 2011, the disclosure of which is incorporated herein by reference. United States Patent Publication No. 2011/0015660 entitled "Rotating Transducer Mount for Ultrasonic Surgical Instruments", "Electrosurgical Sequencing Systems" published on December 31, 2002, the disclosure of which is incorporated herein by reference. U.S. Pat. No. 6,500,176 entitled “ US Patent No. 18/201, entitled “Surgical Instrument Compiling First and Second Drive Systems Actuable by a Common Trigger Measurement” published on Apr. 14, 2011, incorporated herein by reference. Can be mentioned. Further, such a surgical tool includes a cordless transducer such as that disclosed in US Patent Publication No. 2009/0143797 entitled “Cordless Hand-held Ultrasonic Catching Cutting Device” published June 4, 2009. This disclosure may be incorporated herein by reference. Further, the surgical instrument is in a robot-assisted surgical environment such as that disclosed in US Pat. No. 6,783,524 entitled “Robotic Surgical Tool with Ultrasound Customizing and Cutting Instrument” issued August 31, 2004. May be used or adapted to use.

  Although several systems and methods have been created and used for surgical instruments, it is believed that no one has made or used the invention described in the accompanying claims prior to the inventor of the present invention. .

At the end of the specification is appended claims which specifically point out and claim the right of this technology, which reads the description of specific embodiments below in conjunction with the accompanying drawings. It is thought that a deeper understanding can be obtained. In the drawings, like reference numerals indicate like elements.
1 is a perspective view of an exemplary surgical system having a surgical instrument and generator. FIG. FIG. 3 is a partial side view of an exemplary surgical instrument with a portion of the cover removed to show the interior of the coupling housing portion of the exemplary assembled handle assembly. FIG. 3 is a partial perspective view of the distal end of an exemplary transducer. FIG. 3 is a perspective view of an exemplary transmission assembly. FIG. 6 is a partial view of the proximal end of an exemplary transmission assembly coupled to the distal end of an exemplary handle assembly. FIG. 10 is a partial view of the proximal end of another exemplary transmission assembly coupled to the distal end of an exemplary handle assembly. The front view of the typical rotary machine containing a tab. FIG. 8 is a fragmentary perspective view of the representative rotator of FIG. 7. FIG. 8 is a cross-sectional view of the exemplary rotator of FIG. 7 coupled with an exemplary multi-part handle assembly and shaft. FIG. 6 is a perspective view of another variation of the connection of a representative shaft to a drive member. FIG. 10 is a cross-sectional view of another variation of the connection of the exemplary shout to the drive member in the unfixed position. FIG. 12 is a representative shaft and drive member of FIG. 11 in a fixed position. FIG. 6 is a partial view of the proximal end of a transmission assembly coupled to the distal end of the handle assembly. FIG. 14 is a partial view of the transmission assembly of FIG. 13 separated from the handle assembly of FIG. 1 is a front view of an exemplary surgical instrument having a tapered male waveguide end that is configured to be attached without a screw and attached to a corresponding tapered female transducer. FIG.

  The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be implemented in a variety of other ways, including those not necessarily shown in the drawings. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the present technology and, together with the description, serve to explain the principles of the technology. However, it should be understood that this technique is not limited to the exact configuration shown in the figures.

  The following description of a particular embodiment of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will be apparent to those skilled in the art from the following description. The following description is, by way of illustration, one of the best modes contemplated for implementing the technique. As will be appreciated, any of the techniques described herein may implement various other obvious aspects without departing from this technique. Accordingly, the drawings and descriptions are of exemplary nature and should not be considered limiting.

I. Overview of Exemplary Ultrasound Surgical Device FIG. 1 illustrates an exemplary ultrasonic surgical instrument (50), generator (20), and cable (30) that couples generator (20) with surgical instrument (50). 1 shows an ultrasonic surgery system (10). In some variations, the generator (20) is an Ethicon Endo-Surgery, Inc. GEN 300 sold by (Cincinnati, Ohio). By way of example only, generator (20) is disclosed in U.S. Patent Publication 2011/2011 published April 14, 2011 entitled "Surgical Generator for Ultrasonic and Electronic Devices", the disclosure of which is incorporated herein by reference. It can be constructed according to the teachings of 0087212. Surgical instrument (50) is described herein with respect to ultrasonic surgical instruments, but the teachings herein are end cutters, graspers, cutters, staplers, clip appliers, access devices, drugs / genes Including, but not limited to, therapeutic delivery devices and energy delivery devices using ultrasound, RF, laser, etc., and / or any combination thereof as will be apparent to those skilled in the art in view of the teachings herein. It should be understood that it may be applied to various surgical instruments that are not. This example is also described with reference to a surgical instrument (50) with a cable connection, but the surgical instrument (50) is incorporated herein by reference, "Cordless Hand-held Ultrasonic Category". A cordless converter such as that disclosed in US Patent Publication No. 2009/0143797, published June 4, 2009, entitled “Cutting Device” may also be included. For example, the surgical device (50) may include an integrated portable power source such as a battery. In addition, the surgical device (50) is a robotic assisted surgery as disclosed in US Pat. No. 6,783,524 entitled “Robotic Surgical Tool with Ultrasound Customizing and Cutting Instrument” issued August 31, 2004. It may be used or adapted to be used in an environment.

  The surgical instrument (50) of this example includes an assembled handle assembly (60), an elongated transmission assembly (70), and a transducer (100). The transmission assembly (70) is coupled to the assembled handle assembly (60) at the proximal end of the transmission assembly (70) and extends distally from the assembled handle assembly (60). In this example, the transmission assembly (70) is configured to be an elongated thin tubular assembly for an endoscope, but the transmission assembly (70) is alternatively disclosed herein by reference. U.S. Patent Publication No. 2007/0282333 entitled "Ultrasonic Waveguide and Blade" published on Dec. 6, 2007 and "Ultrasonic Device for Cutting and Coagulating" published on Aug. 21, 2008. It should be understood that short assemblies such as those disclosed in US Patent Publication No. 2008/0200940 may be used. The transmission assembly (70) of this example includes an outer sheath (72), an inner tubular actuation member (not shown), a waveguide (not shown), and an end effector (80 at the distal end of the transmission assembly (70). ). In this example, the end effector (80) is a clamp that is operable to pivot at the proximal end of the blade (82), transmission assembly (70) mechanically and acoustically coupled to the waveguide (76). It has an arm (84) and a clamp pad (86) coupled to the clamp arm (84). Clamp arm (84) and related features are also described in U.S. Pat. No. 5,989,959 entitled "Ultrasonic Clamp Coagulator Apparatus Improving Clamp Arm Pivot Mount," the disclosure of which is incorporated herein by reference. It should be understood that it may be configured and operable according to at least some of the teachings of US Pat. No. 5,980,510. Exemplary variations of the end effector (80) and transmission assembly (70) are described in more detail with respect to the example shown in FIG.

  In some variations, the transducer (100) was compressed between a first resonator (not shown) and a second resonator (not shown) to form a stack of piezoelectric elements. It has a plurality of piezoelectric elements (not shown). The piezoelectric element may be made from any suitable material, such as, for example, lead zirconate titanate, lead metaniobate, lead titanate, and / or any suitable piezoelectric crystal material, for example. The transducer (100) further comprises an electrode including at least one positive electrode and at least one negative electrode configured to generate a potential on both sides of the one or more piezoelectric elements, the piezoelectric element comprising: Is converted into ultrasonic vibration. Ultrasonic vibrations are transmitted to the blade (82) via the waveguide in the transmission assembly (70).

  The assembled handle assembly (60) of this example has a coupling housing portion (62) and a lower portion (64). The coupling housing portion (62) houses the transducer (100) at the proximal end of the coupling housing portion (62) and the proximal end of the transmission assembly (70) at the distal end of the coupling housing portion (62). Configured as follows. In this example, a rotation knob (66) is shown that rotates the transmission assembly (70) and transducer (100), but it should be understood that the rotation knob (66) is merely optional. The coupling housing portion (62) is described in more detail later with respect to FIG. The lower portion (64) of the assembled handle assembly (60) shown in FIG. 1 has a trigger (68) and is configured to be grasped by a user using one hand. One exemplary variation of the lower portion (64) is shown in FIG. 1 of US Patent Publication No. 2011/0015660, published January 20, 2011, entitled “Rotating Transducer Mount for Ultrasonic Surgical Instruments”. The disclosure of this patent is hereby incorporated by reference. The toggle button (69) shown in FIG. 2 of the present disclosure is located on the distal surface of the lower portion (64) and uses the generator (20) to selectively move the transducer (100) at different operating levels. It is operable to actuate. For example, the first toggle button (69) can operate the transducer (100) at a maximum energy level, and the second toggle button (69) operates the transducer (100) at a non-zero minimum energy level. be able to. Of course, the toggle button (69) may be configured at energy levels other than the maximum and / or minimum energy levels, as will be apparent to those skilled in the art in view of the teachings herein. Further, the toggle button may be located anywhere on the assembled handle assembly (60), the transducer (100), and / or away from the surgical instrument (50), and any number of toggle buttons may be May be provided. Although the assembled handle assembly (60) has been described with respect to two separate parts (62, 64), it should be understood that the assembled handle assembly (60) may be a unitary assembly in which both parts (62, 64) are combined. I want you to understand. The assembled handle assembly (60) may alternatively be divided into a plurality of individual parts such as a separate trigger portion (operable by the user's hand or leg) and a separate coupling housing portion (62). Such a trigger portion may be operable to actuate the transducer (100) and may be remote from the coupling housing portion (62). As will be apparent to those skilled in the art in view of the teachings herein, the assembled handle assembly (60) may be made of durable plastic (such as polycarbonate or liquid crystal polymer), ceramic, metal, or any other suitable material. It may be configured. Also, other configurations of the assembled handle assembly (60) will be apparent to those skilled in the art in view of the teachings herein. By way of example only, surgical instruments (50) are disclosed in US Patent Publication Nos. 2006/0079874, 2007/0191713, 2007/0282333, 2008/0200940, 2011/0015660, US Patents. It may be configured according to at least some of the teachings of US Pat. No. 6,500,176, US Patent Publication Nos. 2011/0087218 and / or 2009/0143797.

  Further, any one or more of the teachings, expressions, embodiments, examples, etc. described herein are combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Please understand that you can. Accordingly, the teachings, expressions, embodiments, examples and the like described below should not be considered independent of each other. Various suitable ways in which the teachings herein can be combined will be readily apparent to those skilled in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

II. Exemplary Coupling Assembly of an Ultrasonic Surgical Instrument In some instances, it may be useful to separate the transmission assembly (70) from the assembled handle assembly (60) and the transducer (100). For example, the separable transmission assembly (70) allows reuse of the assembled handle assembly (60) with multiple transmission assemblies (70) having various end effectors (80). By way of example only, various end effectors (80) may have blades (82) having different sizes and / or shapes, or various end effectors (80) may be RF end effectors, stapling end effectors. It may have completely different functions such as a cutting end effector. In addition, a single assembled handle assembly (60) removes the dirty transmission assembly (70), cleans the assembled handle assembly (60) if necessary, and a new transmission assembly (70) for a new operation. ) To the assembled handle assembly (60) may be reused for various operations by the user. Thus, depending on the user of the surgical instrument (50), it may be desirable to configure the assembled handle assembly (60) to couple with the various transmission assemblies (70).

A. Exemplary Assembled Handle Assembly FIG. 2 shows an assembly with a portion of the cover (61) removed to show the internal components housed within the coupling housing portion (62) and a cross section of the lower portion (64). FIG. 6 shows a partial side view of a shaped handle assembly (60). As described above, the lower portion (64) has a pivoting trigger (68) and a pair of toggle buttons (69). The trigger (68) in this example is pivotable from a distal open position to a proximal closed position. The trigger assembly (150) is coupled to the trigger (68) and is pivotally supported within the assembled handle assembly (60). The trigger assembly (150) of this example includes a pivotable mounting arm (152) that can be pivoted about a pin (not shown), a trigger arm (154), an intermediate coupling member (156), and an actuation arm ( 158). Actuating arm (158) is coupled to trigger yoke (170) at the distal end of actuating arm (158). Actuating arm (158) includes one or more mounting pins (160) projecting outwardly from actuating arm (158), which includes a corresponding elongated channel (160) formed in cover (61). 162) is sized to be slidably accommodated within 162). Thus, when trigger (68) is pivoted proximally from the open position to the closed position, mounting arm (152) and trigger arm (154) pivot within assembled handle assembly (60). An intermediate coupling member (156) coupled to the trigger arm (154) transmits this pivoting motion from the trigger arm (154) to the actuating arm (158) via a pin (160) in the channel (162). The actuator arm (158) is slidably translated in the proximal direction. A trigger yoke (170) coupled to the actuation arm (158) is also translated proximally. In this example, the trigger yoke (170) is coupled to a force limiting mechanism (180), which is further coupled to the transmission assembly (70) as will be described in more detail later, The operating member (74) is operated. The cavity (140) shown in FIG. 2 is configured to receive the transducer (100) from the transducer opening (142) formed in the cover (61). The cavity (140) is configured to receive at least a portion of the transducer (100) so that the transducer (100) and the transmission assembly (70) can be coupled. Furthermore, other configurations of the assembled handle assembly (60) will be apparent to those skilled in the art in view of the teachings herein.

B. Exemplary Transducer As shown in FIG. 3, the transducer (100) of this example is a tubular component coupled to the generator (20) via a cable (30), but instead the transducer (100) It should be understood that a cordless transducer may be used. For example, the transducer (100) may instead receive power from a power source housed within the handle assembly (60) in accordance with the teachings of various references cited or otherwise cited herein. . In this example, the transducer (100) has a first conductive ring (102) and a second conductive ring (104) disposed within the body (110) of the transducer (100). In this example, the first conductive ring (102) is disposed on the ring member and is configured to electrically couple the first conductive ring (102) to a power source. A ring member having a contact is included. The first conductive ring (102) is disposed between the body (110) and a horn (120) extending distally from the body (110). As described below with respect to FIG. 4, the horn (120) has a distal horn thread (122) so that the horn (120) can be coupled to the waveguide (210). The first conductive ring (102) in this example is coaxial and adjacent to the flange (106). The flange (106) in this example is configured to further mechanically couple the transducer (100) within the assembled handle assembly (60). The transducer cavity (108) is disposed between the first conductive ring (102) and the second conductive ring (104) so that the first conductive ring (102) is the second conductive ring (102). Electrically conductive ring (104) and / or other conductive components of transducer (100). The first conductive ring (102) is disposed on a non-conductive platform that extends distally from the body (110). The first conductive ring (102) is electrically coupled to the cable (30) shown in FIG. 1 by one or more wires or conductive etching (not shown) in the body (110). The Such electrical coupling of the first conductive ring (102) to the cable (30) may include a slip ring that facilitates free rotation of the transducer (100) relative to the cable (30).

  Similarly, the second conductive ring (104) of the transducer (100) has a ring member disposed between the body (110) and the horn (120). The second conductive ring (104) is disposed between the first conductive ring (102) and the horn (120). As shown in FIG. 3, the first and second conductive rings (102, 104) are coaxial members. Similarly, the second conductive ring (104) is electrically isolated from the first conductive ring (102) and other conductive components of the transducer (100). Similar to the first conductive ring (102), the second conductive ring (104) extends from the non-conductive platform. One or more washer spacers between the second conductive ring (104) and the horn (120) to isolate vibrations transmitted from the horn (120) from other components of the transducer (100). (112) may be arranged. The second conductive ring (104) is also electrically coupled to the cable (30) shown in FIG. 1 by one or more wires or conductive etch (not shown) in the body (110). The Also, such electrical coupling of the second conductive ring (104) to the cable (30) may have a slip ring that facilitates free rotation of the transducer (100) relative to the cable (30). . One merely exemplary suitable ultrasound transducer (100) is available from Ethicon Endo-Surgery, Inc. Although it is model number HP054 sold by (Cincinnati, Ohio), it should be understood that other suitable transducers can also be used.

  As shown in this example, the distal end of the transducer (100) is threadedly coupled to the proximal end of the transmission assembly via a horn (120). The distal end of the transducer (100) is also connected to one or more electrical connections (not shown) via first and second conductive rings (102, 104) to toggle the transducer (100). Electrically coupled to the button (69) and providing the user with a finger control mechanism for actuating the transducer (100) during use of the surgical instrument (50). At the interface between the one or more electrical contacts and the first and second conductive rings (102, 104), the transducer (100) is free to rotate relative to the multi-part handle assembly (60). A slip ring connection may be included. Other configurations of the transducer (100) will be apparent to those skilled in the art in view of the teachings herein. For example, the first and second conductive rings (102, 104) may be omitted from the distal end of the transducer (100), and the electrical coupling of the transducer (100) to the toggle button (69) is Achieved by alternative structures such as a conductor at the proximal end of the transducer (100), a conductor disposed along the side of the body (110) of the transducer (100), directly from the cable (30), and / or otherwise. May be. When the transducer (100) of this example is activated via the toggle button (69), the transducer (100) is mechanical energy in the form of oscillations or vibrations at ultrasonic frequencies (such as 55.5 kHz). Is operable to produce When the transducer (100) is coupled to the transmission assembly (70) via the horn (120), such mechanical vibrations are transmitted to the end effector (80) via the transmission assembly (70) internal waveguide. Is done. In this embodiment, when the blade (82) is connected to the waveguide, this causes the blade (82) to vibrate at an ultrasonic frequency. Therefore, when the tissue is clamped between the blade (82) and the clamp arm (84), the ultrasonic vibration of the blade (82) simultaneously cuts the tissue and denatures the protein in adjacent tissue cells. And thereby provide a coagulation effect with relatively little thermal diffusion. Current may also be provided through the blade (82) and the clamp arm (84) to cauterize the tissue. Although several configurations of the transmission assembly (70) and transducer (100) have been described, in view of the teachings herein, other configurations suitable for the transmission assembly (70) and transducer (100) are possible. It will be clear to the contractor.

C. Exemplary Transmission Assembly for Threaded Mounting As previously indicated, in some instances it may be useful to separate the transmission assembly (70) from the assembled handle assembly (60) and the transducer (100). is there. For illustrative purposes only, the use of an assembled handle assembly (60) having a plurality of transmission assemblies (70) with blades (82) of different sizes and / or shapes, entirely different functions and / or styles (e.g. Use with various end effectors (80) having RF end effectors, stapling end effectors, cutting end effectors, etc., or reuse of a single assembly handle assembly (60) for multiple operations by the user. It is done. Accordingly, variations that allow a user to replace the transmission assembly (70) with the assembled handle assembly (60) may be useful.

  4 shows the proximal end (202), distal end (204), waveguide (210), inner tubular actuation member (220), outer sheath (230), and end of the distal end of the transmission assembly (200). One merely exemplary transmission assembly (200) having an effector (240) is shown. In this embodiment, the waveguide (210), the inner tubular actuating member (220), and the outer sheath (230) are centered on the waveguide (230), and the inner operating member (220) is the waveguide ( 210), and the outer sheath (230) is a concentric member disposed outside the inner operating member (220).

  Referring to the distal end (204) of the transmission assembly (200), the first end effector (240) includes a blade (242), a clamp arm (244), and one or more optional clamp pads (246). ). In this example, the blade (242) is coupled to the waveguide (210), whereby mechanical vibrations transmitted from the transducer (100) to the waveguide (210) are also transmitted to the blade (242). Only exemplary coupling of blade (242) to waveguide (210) includes welding of blade (242) to waveguide (210), integral formation of waveguide (210) and blade (242), waveguide Mechanical or chemical bonding of the blade (242) to (210) and / or other suitable configurations as will be apparent to those skilled in the art in view of the teachings herein. In some variations, blade (242) is a curved blade, such as blade (242) shown in FIG. 4, and in some variations, blade (242) may be a straight blade. Further, the blade (242) may have various shapes and sizes. In this example, the blade (242) is a tapered rectangular blade, but the blade (242) may be cylindrical, triangular, semi-cylindrical, square, hooked, and / or any other shape for the blade (242). I want you to understand. Additionally, additional features may be added to the blade (242), including spherical tips, hook tips, square tips, serrated edges, and / or other additional features. Still other configurations of the blade (242) will be apparent to those skilled in the art in view of the teachings herein.

  The clamp arm (244) of this example is a bending member corresponding to the bending of the blade (242). The clamp arm (244) may have a clamp pad (246) that grasps or secures tissue against the blade (242), if desired. Such a clamp pad may be composed of at least some of the teachings of US Patent Publication No. 2006/0079874, published on Apr. 13, 2006, entitled “Tissue Pad Use with an Ultrasonic Surgical Instrument”. The pivoting movement of the clamp arm (244) relative to the blade (242) includes a first pair of pivot points (248) on the clamp arm (244) that pivotally couple to the outer sheath (230) and inner tubular actuation. And a second set of pivot points (249) on clamp arm (244) that pivotally couple to member (220). In this example, the outer sheath (230) can be coupled to the assembled handle assembly (60) via the rotary knob (250), thereby grounding the outer sheath (230). A first set of pivot points (248) of the clamp arm (244) are pivotally connected to the outer sheath (230) via corresponding through holes (232) on the outer sheath (230). In some variations, the first set of pivot points (248) has a through hole and a securing pin or rivet that secures the clamp arm (244) to the outer sheath (230) is provided in the first set of pivots. The moving point (248) and the through hole (232) may be inserted. The pin of this variation may be laser welded to the clamp arm (244) and the pin may be laser welded to the outer sheath (230). Of course, alternatively, the through hole (232) may be an outwardly projecting pin, and the first set of pivot points (248) may be a through hole. Still other configurations of the first set of pivot points (248) and through holes (232) will be apparent to those skilled in the art in view of the teachings herein.

  A second set of pivot points (249) of the clamp arm (244) are pivotally connected to the inner tubular actuating member (220) via corresponding through holes (222) on the inner tubular actuating member (220). Is done. In some variations, the second set of pivot points (249) has through-holes, and the second set of locking pins or rivets that secure the clamp arm (244) to the inner tubular actuating member (220). The pivot point (249) and the through hole (222) may be inserted. The pin in this variation may be laser welded to the clamp arm (244) and the pin may be laser welded to the inner tubular actuating member (220). Of course, alternatively, the through hole (222) may be an outwardly projecting pin, and the second set of pivot points (249) may be a through hole. Still other pivotable configurations of the second set of pivot points (249) and through holes (222) will be apparent to those skilled in the art in view of the teachings herein.

  With the clamp arm (244) so secured to the outer sheath (230) and the inner tubular actuating member (220), the clamp arm (244) is translated when the inner tubular actuating member (220) translates longitudinally. Can pivot. In this example, the inner tubular actuation member (220) is translatable relative to the longitudinal axis of the outer sheath (230) and is coupled to a force limiting mechanism (180) in the assembled handle assembly (60). Thus, when the force limiting mechanism (180) is translated by the trigger (68) and trigger assembly (150), the clamp arm (244) is pivotable from the open position to the closed position. As with the other components referenced herein, it should be understood that the clamp arms (84, 244) are merely an option. Similarly, the trigger (68), trigger assembly (150), and components described herein to pivot the clamp arms (84, 244) are merely options. Thus, some variations of the end effector (80, 240) may simply consist of blades (82, 842) and / or other features.

  As shown in FIG. 4, a spacer (290) can be inserted between the clamp arm (244) and the blade (242) to maintain the clamp arm (244) in the open position. In this example, the spacer (290) has a flat lower surface (292) and an oblique upper surface (294). The upper surface (294) is diagonally set to maintain the clamp arm (244) in the open position relative to the blade (242) when the lower surface (292) abuts the blade (242). In some variations, the lower surface (292) may be configured to snap or clip to the blade (242) to secure the spacer (290) to the blade (242). Alternatively, the spacer (290) may be recessed so that the spacer (290) can slide on the blade (242). Furthermore, an adhesive may be applied to the lower surface (292) and / or the upper surface (294) to secure the spacer (290). This prevents the clamp arm (244) from pivoting to the closed position when the spacer (290) is inserted between the clamp arm (244) and the blade (242). This allows the user to couple the transmission assembly (200) to the assembled handle assembly (60) while maintaining both the clamp arm (244) and the trigger (68) in their respective open positions. Alternatively, the user may couple the transmission assembly (200) to the assembled handle assembly (60) without using the spacer (290). For example, a user may couple different components of the transmission assembly (200) to different components of the handle assembly (60) at different times in the manner described below or otherwise.

  Referring now to the proximal end (202) of the transmission assembly (200), the rotation knob (250) couples the outer sheath (230) to the multi-piece handle assembly (60). In this example, the rotary knob (250) includes an inner ring portion (not shown) having one or more connectors (252) extending proximally, an outer ring (254), and an outer ring (254). A pin (not shown), an outer sheath (230), an inner tubular actuating member (220), and a waveguide (210). Thus, when the outer ring (254) of the rotation knob (250) is rotated, the waveguide (210), inner tubular actuating member (220) and outer sheath (230) also rotate. Inner ring portion and outer ring (254) in this example are complementary bearing components such that outer ring (254) can rotate relative to the inner ring portion. It should be understood that the pin does not pass through the inner ring portion. As described above, the inner ring portion has a connector (252). In this example, connector (252) is shown as a snap-fit connector, but as will be apparent to those skilled in the art in view of the teachings herein, threading, adhesive, pins, clips, snaps, and / or others Other suitable connection features such as connectors may be used. As described below, when the transmission assembly (200) is assembled with the assembled handle assembly (60) and the transducer (100), the connector (252) of this example has one or more indentations (not shown). ) To couple the rotary knob (250) to the cover (61) of the assembled handle assembly (60). On the assembled handle assembly (60) or rotary knob (250), there is a release mechanism such as a push button (not shown) for disconnecting the connector (252) from the cover (61) when removing the transmission assembly (200). It may be provided. Alternatively, the connector (252) may be designed to detach when the transmission assembly (200) is disconnected. Further, if threading is used, the inner portion of the rotary knob (250) may be rotated away from the assembled handle assembly (60). Still other suitable configurations of the rotary knob (250) will be apparent to those skilled in the art in view of the teachings herein.

  With further reference to the proximal end (202) of the transmission assembly (200), it has an external thread (228) at the proximal end of the inner tubular actuation member (220) as shown in FIG. Male thread (228) fits into a complementary thread (not shown) of force limiting mechanism (180), which is driven by trigger assembly (150). Further included is a recess having an internal thread (218) at the proximal end of the waveguide (210) as shown in FIG. The female thread (218) fits into the horn thread (122) to mechanically and acoustically couple the waveguide (210) to the transducer (100). Of course, other configurations suitable for the transmission assembly (200) will be apparent to those skilled in the art in view of the teachings herein. Similarly, various other suitable ways in which the transmission assembly (200) can be coupled to the handle assembly (60) will be apparent to those skilled in the art in view of the teachings herein.

III. Exemplary removable shaft connection to the handle portion The variations described below deal with the connection and use of the disposable transmission assembly, another variation of the transmission assembly (70) described above. Another variation of the transmission assembly (70) allows another transmission assembly to be selectively connectable and adjustable with the transducer (100) at the corresponding reusable handle portion of the ultrasonic surgical instrument. Such a component is included. Additional exemplary modifications that can be provided for the multi-piece handle assembly (60) of the instrument (50) and the transmission assembly (70) that can be selectively coupled to the transducer (100) include the following: Will be described in more detail. Various suitable ways in which the following teachings may be employed in the instrument (50) will be apparent to those skilled in the art. Similarly, various suitable ways in which the following teachings can be combined with the various teachings of the references cited herein will be apparent to those skilled in the art. Also, it should be understood that the following teachings are not limited to the instrument (50) or apparatus taught in the references cited herein. The following teachings can be readily applied to various other types of instruments, including instruments that are not classified as ultrasonic surgical instruments. Various other suitable devices and environments to which the following teachings can be applied will be apparent to those skilled in the art in view of the teachings herein.

A. Exemplary Ball Detent Connection FIG. 5 shows the connection of the yoke (170) to the force limiting mechanism (180) of the transmission assembly (70). The yoke (170) includes a column (300) captured in a notch (302) in the force limiting mechanism (180). The column (300) has a high proximal closing force to drive the end effector clamping part and a smaller proximal for incision in order to better heal the vessel during cutting. Transmits force such as opening force toward the direction.

  FIG. 6 shows a ball detent assembly (with a spring mounted in the yoke (306), rather than a post that is secured in the notch (308), defined in the proximal end (310) of the transmission assembly (312). 304) shows another variation. The spring loaded ball detent assembly (304) includes a ball bearing or detent (314) attached to the end of a biasing member, such as a spring (316). The detent (314) assists in connecting the transmission assembly (312) to the engaging housing portion (62A) of the cover (61A) of the surgical instrument (50A). Surgical instrument (50A) is similar to surgical instrument (50) described above, except for the differences described below with respect to the connection and removal of transmission assembly (312) from and to surgical instrument (50A), respectively. It is. The same is true for other variations of surgical instruments described below and herein. Similarly, variations of the transmission assembly described below and herein are each a rotating knob, such as knob (66A), and a shaft, such as outer sheath (317) (which is the outer sheath of transmission assembly (70)). (72) and the outer sheath (230) of the transmission assembly (200)). The outer sheath (317) can rotate relative to the hand piece of the instrument (50A) but does not translate relative to the hand piece.

  When connecting the transmission assembly (312) to the reusable handle portion of the surgical instrument (50A), the proximal end (310) of the assembly (312) causes the detent (314) to move outward from the assembly (312). Push away until the detent (314) is aligned with the notch (308), at which point the spring (316) biases the detent (314) into engagement with the notch (308). Add This force removably connects assembly (312) with yoke (306) of instrument (50A). The yoke (306) is similar to the yoke (170) of the transmission assembly (70). The yoke (306) translates within the handpiece of the instrument (50A) based on the pivoting movement of the trigger (not shown) relative to the handpiece, and the trigger structure and operation is the trigger (68) of the transmission assembly (70). It is the same. The proximal end (310) of the assembly (312) includes an inner tube portion similar to the inner tube actuation member (220) of the transmission assembly (200). The inner tube portion of the proximal end (310) includes an inner tube that translates within the yoke (306) relative to the handpiece of the instrument (50A) and extends through and translates within the outer sheath (317). When the inner tube translates in a first direction (eg, proximal direction), the inner tube pivots the clamp arm (244) toward the blade (242). When the inner tube translates in a second opposite direction (eg, distal direction), the inner tube pivots the clamp arm (244) away from the blade (242).

  In some other form, the inner sheath may remain static while the outer sheath (317) translates distally to close the clamp arm (244) relative to the blade (242). As another merely exemplary variation, the inner tube may engage a pivot point on the clamp arm (244), the outer sheath (317) may engage a fixed driver pin, Thus, distal movement of the inner tube allows the clamp arm (244) to be closed relative to the blade (242). Yet another merely exemplary variation includes having both a pivot pin and a drive pin positioned on the upper side of the clamp arm (244), with the drive pin positioned slightly above the pivot pin. Thereby translating the inner tube distally closes the clamp arm (244) relative to the blade (242). In yet another variation, an isolation yoke surface (318), described in more detail below, is disposed at the distal end of the yoke (306) and the proximal end of the assembly (312) is disposed thereon during insertion. It may include a lip that fits in. Such insertion and construction is such that when the assembly (312) is thus attached to the yoke (306), a strong proximal traction force is applied against a weaker distal pushing force. Enable. Other suitable ways in which the clamp arm (244) can be actuated will be apparent to those skilled in the art in view of the teachings herein.

  The waveguide (320) is similar to the waveguide (210) of the transmission assembly (200) and is coaxially positioned within the outer sheath (317) and within the inner tube. The waveguide (320) extends proximally relative to the proximal end (310) of the assembly (312) and couples with a transducer (not shown).

  After the connection to the yoke (306) is made, the assembly (312) can be rotated and further screwed to the transducer as described with respect to FIGS. Once in place, the proximal end (310) of the assembly (312) is flush with the isolation yoke surface (318). The isolation yoke surface (318) includes an opening for receiving the waveguide (320) of the assembly (312). The isolation yoke surface (318) pushes the proximal end (310) of the assembly (312) to allow a strong distal pushing force against the assembly (312) and at the same time a weaker proximal traction force. , Function as "offset". Closing the end effector clamp arm of the assembly (512) is accomplished by pulling the inner tube of the assembly (512) through the yoke (306), the proximal end of the assembly (312) relative to the yoke (306). (310) is flush with isolation surface (318), allowing sufficient force to open the end effector and loosen the end effector from the tissue.

  When the end effector opens, the detent (314) pulls the proximal end (310) of the assembly (312) without disengaging from the assembly (312). However, if the user desires to replace the assembly (312), the user will be able to provide sufficient force to remove the assembly (312) from the reusable handle portion of the instrument (50A). The detent (314) can be separated from the assembly (312).

B. Exemplary Rotator Connections FIGS. 7-12 illustrate three exemplary rotator connections to an ultrasonic surgical instrument to provide attachment and separation of the transmission assembly to the handle of the surgical instrument. Two variations are shown. The first variation shown in FIGS. 7-9 is directed to a shaft connection method that includes a detent of the cylindrical portion of the rotator and a spring return. The second variation shown in FIG. 10 uses a shaft connection method that includes a retaining ring. The third variation shown in FIGS. 11 and 12 uses a shaft connection method that includes a resiliently biased clamping component in the form of multiple holding arms.

1. Exemplary Detent and Spring Return Variations FIG. 7 shows a rotator (350) that includes a knob portion (352) and a proximal portion (354) that projects laterally from the knob portion (352). The proximal portion (354) includes a tab (356) protruding from the cylindrical portion (358). The rotator (350) includes a longitudinal axis (A), which in FIG. 7 divides the rotator (350) into two parts. FIG. 8 shows a fragmentary perspective view of one of these parts. The tab (356) protrudes from the free end of the resilient arm (360).

  FIG. 9 shows a cross-sectional view of the rotator (350) as part of the transmission assembly (362) inserted into the distal end (364) of the ultrasonic surgical instrument. The assembly (362) includes a pair of stops (366) that capture the distal wall (370) of the rotator (350). The distal wall (370) and other outer walls of the rotator (350) define an interior hollow space (372) through which the interior tube (375) passes. The inner tube (375) translates within the outer sheath (374). The distal end (376) is an inner tube at a position aligned with the proximal end of the cylindrical portion (358) when the assembly (362) is fully inserted into the distal end (364) of the instrument. (375) fixedly disposed at the proximal end. A biasing member, such as a spring (378), is disposed between one of the stops (366) and the end (376). The distal end (376) biases the inner tube (375) proximally, thereby biasing the clamp arm (244) toward the closed position (pivoted toward the blade (242)). ).

  In addition, when the assembly (362) is first inserted into the distal end (364) of the instrument, the tab (356) is an opening formed in the distal end (364) that receives the assembly (364). Pressed inward against the part. The cylindrical wall (380) defines an opening in the shelf (382). When the assembly (362) is fully inserted into the distal end (364) of the instrument, the tab (356) releases the cylindrical wall (380) and the spring, thereby causing each tab (356) to be The top surface is flush with the ledge (382) to prevent the assembly (362) from undesirably disengaging from the distal end (364). The rotator (350) is then pressed, for example, with the user's finger on the tab (356) and the detent or tab (356) is released back through the opening defined in the wall (380). May be removed.

  The drive member (384) engages the end piece (376) when the assembly (362) is fully positioned within the handpiece. The drive member (384) is actuated via the yoke mechanism in the manner previously described with respect to the surgical instrument (50) to compress the spring (378) in such a manner as to close the connected end effector; The inner tube (375) may be pushed in the distal direction (again described above with respect to instrument (50)). By releasing the trigger, the spring (378) is released from the compressed state, whereby the biasing force of the spring (378) drives the inner tube (375) proximally and reopens the clamped end effector. (Above). The inner tube (375) described above is described as a clamp arm actuation tube for an ultrasonic surgical instrument (50), but similar inner members are described in various references cited herein. Can be used as a firing beam for high frequency based surgical instruments, or surgical stapling instruments (eg, end cutters, etc.), including but not limited to variations of such instruments.

2. Exemplary Ring Variation FIG. 10 illustrates a method of connecting the distal end (376) of FIG. 9 to the drive member (384) of FIG. The retaining ring (404) is disposed in a groove in the proximal portion of the distal end (376) between the proximal end (406) and the stop (408). The ring (404) helps retain the distal end (376) in the drive member (384) while being located around the inner tube (375) when the instrument trigger is not released. (378) helps return the end (376) to the initial original position in the direction of arrow (B). The ring (404) has a radial spring characteristic that allows the ring (404) to compress as the distal end (376) is inserted into the drive member (384). For example, the ring (404) may include a gap so that when the ring (404) is driven into the first internal bore (412) of the drive member (384) described below, the effective diameter of the ring (404) is reduced. Allows to be reduced.

  The end (376) is inserted into the drive member (384) in the direction of the arrow (B). The drive member (384) includes a first internal bore portion (412) that is narrower than the portion (412) and via the shelf (416) against which the proximal end (406) abuts the portion (412). Disposed from the second inner bore (414) distally. The first internal bore portion (412) of the drive member (384) also includes an annular groove (418) configured to receive the ring (404). The ring (404) has sufficient holding force to transfer the force from the spring (378) to return the distal end (376) to the original original position, but such holding force is applied to the transmission assembly ( This may be overcome to remove the distal end (376) from the drive member (384) by pulling 362) distally. Alternatively, the ring (404) may be positioned on a portion of the instrument handle rather than the end (376) to serve as a retaining means for the groove of the end (376).

3. Exemplary Holding Arm Variations FIGS. 11-12 show an inner tube (453) that translates inward to drive member (452) through a resiliently biased clamping component (454). FIG. 6 illustrates another method of connecting another variation of the shaft assembly (450), including an outer sheath (451). For example, FIG. 12 shows a method of connecting a variation of the inner tube actuation member (220) to the yoke (170) and force limiting mechanism (180) of the transmission assembly (70), where the inner tube (453) is , Similar to the internal annular actuating member (220). The shaft assembly (450) is still used with the rotator (350) described above to hold the transmission assembly to the instrument.

  The drive member (452) shown in FIG. 11 includes a groove (456) formed in the distal end (458) of the drive member (452). The groove (456) is configured to receive a wedge (460) extending inwardly from the retaining arm (462) of the component (454). The holding arm (462) is urged outwards naturally or elastically. The component (454) is disposed at the proximal end (464) of the inner tube (453) of the shaft assembly (450). The component (454) can be molded into the described shape, or can be a stamped metal, such as spring steel, or other such suitable material.

  The component (454) of the inner tube (453) is circularly recessed within the distal end (468) of the instrument handpiece (not shown) in the direction of arrow (C), as shown in FIG. When inserted into (466), shaft assembly (450) is advanced until proximal end (470) abuts the surface of distal end (458) of drive member (452). In this regard, the proximal end (472) of the rotator (350A), including the proximal depression, receives the distal end (474) of the component (454) and clamps its periphery. The inner wall defining the proximal depression of the proximal end (472) of the rotator (350A) continues to advance over the retaining arm (462), and the wedge (460) is grooved (as shown in FIG. 12). 456) squeeze arm (462) inward until received in 456). Once the rotator (350A) is fully inserted into the distal end (468) of the instrument, the arm (462) is moved distally by the rotator (350A) out of the distal end (468) of the instrument. Until it is moved in a direction (at this point the arm (462) urges outward to its natural position, releasing the drive member (452) from the shaft assembly (450)) and cannot be opened toward the natural position. . One or more additional components may be provided to selectively secure the rotator (350A) to the distal end (468) of the instrument. Various suitable forms that such components may take will be apparent to those skilled in the art in view of the teachings herein.

C. Exemplary Ball Bearing Compression Fixed Connection FIGS. 13-14 illustrate the connection of another transmission assembly (500) to the handle portion (502) at the distal end (504) of the surgical instrument (50C). The assembly (500) includes a rotation knob (506) to which a shaft portion (508) including a tube that is part of a transmission assembly such as the transmission assembly (70) described above is connected. The difference lies in the ball bearing method of connecting the shaft portion (508) to the knob (506). In particular, as shown in FIG. 13, the drive member (510) is connected to the inner tube (512) through a ball bearing (514). FIG. 14 shows an inner tube (512) that is advanced proximally in the direction of arrow (D). The inner tube (512) includes an inner circular wall (516) that defines an inner depression (518). An annular notch (520) is further defined in the wall (516). The notch (520) is configured to receive a ball bearing (514).

  During assembly, the waveguide (522) is advanced in the direction of arrow (E) in both the inner tube (512) and the recess within the drive member (510). Waveguide (522) includes a tapered proximal end (524) that causes ball bearing (514) to taper end as taper end (524) advances in the direction of arrow (E). Engage with the part (524) to climb the expanding inclined surface and engage with the notch (520) by the cam force applied by the waveguide (522). Strong engagement allows for a high load fit with a shorter longitudinal slope to absence of slope. Also, the inner tube (512) may further rotate with respect to the drive member (510).

  The outer tube (526) and the inner tube (512) connect to the knob (506) via a bayonet lock, including pin and slot type fasteners. For example, the outer tube (526) is screwed and secured into an annular boss (not shown) in the rotating knob (506) and secured to the knob (506), which functions as a mechanical screwing component. To do. After connection, the shaft components of transmission assembly (500) may rotate together and may be further removable from handle portion (502). In addition, the knob (506) of this embodiment is detachably connected to the handle portion (502). Inner tube (512) is similar to inner tube actuating member (220) of transmission assembly (200). The inner tube (512) thus drives the clamp arm and causes the blade to move so that the member (220) drives the clamp arm (244) and pivots relative to the blade (242) as described above. It functions to pivot with respect to it.

D. Exemplary Tapered Waveguide Connection In some variations, the waveguide may be attached to the transducer by a non-threaded connection to engage the transmission assembly with the reusable handle. For example, FIG. 15 shows connections within a typical ultrasonic surgical instrument (50D) and the like. The shaft assembly (550) includes a shaft (552). Waveguide (554) extends from the proximal end (556) of shaft (552). The waveguide (554) includes a male end feature (555). In this example, the male feature (555) is tapered, but the male end feature (555) is suitable for those skilled in the art in view of the teachings herein, such as, for example, a flat shape or a spherical shape. It should be understood that various other suitable shapes may be apparent. A slip nut (558) is disposed around the shaft (552). The slip nut (558) is configured to contact a contact pin (560) that is attached to a longitudinally oscillating node of the waveguide (554). A threaded cap or slip nut (558) presses against the knot pin (560) at the node and is threaded between the waveguide (554) and the transducer (566) as described below. Without using a connection, a compression load is created to couple the waveguide (554) to the transducer (566). In addition, the slip nut (558) can act as a seal. A possible sealing position is at the notch (559) formed between the distal end (561) and the thread (563) of the slip nut (558).

  The slip nut (558) is also configured to be screwed into the handle assembly (562) of the instrument (50D). The threaded connection propels the end feature (555) of the waveguide (554) into the cavity (564), which in this example is tapered and along the direction of the arrow (F), Defined within the horn of the transducer (566). The cavity (564) will be apparent to those skilled in the art in view of the teachings herein, such as a flat shape or a conical shape, to receive an end feature (555) such as a flat shape or a spherical shape, respectively. It can have various other suitable shapes. In particular, cavity (564) is configured to receive a correspondingly configured end feature (555). The spring mechanism (not shown) of the slip nut (558) or the transducer (566) is such that an excessive force exceeding the desired amount is supplied to the connection of the waveguide (554) and the transducer (566). It may act to prevent. For example, in some variations, the pin (560) may fit inside the inner diameter of the slip nut (558), which includes a compression spring (not shown) therein. The distal end of the compression spring is located relative to the proximal portion of the recess in the slip nut (558). A drive plate (not shown) is disposed at the proximal end of the compression spring. The drive plate is configured to fit within the recess of the slip nut (558). The drive plate contacts the pin (560) via a compression spring and limits the force applied to the pin (560). Other suitable force limiting mechanisms and configurations will be apparent to those skilled in the art in view of the teachings herein.

  The spring stack washer (570) is similar to the force limiting mechanism (180) of the transmission assembly (70). The handle assembly (568) interacts with the spring-laminated washer (570) for actuation when the trigger (572) is squeezed and as a result the spring (573) is compressed. In a manner similar to that described above for instrument (50), this compression drives the inner tube of shaft (552) forward and closes end effector (574). In use, the shaft assembly (550) is disposable and can be attached to the reusable handle of the instrument (50D).

  Any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Please understand that you can. Accordingly, the teachings, expressions, embodiments, examples and the like described below should not be considered independent of each other. Various suitable ways in which the teachings herein can be combined will be readily apparent to those skilled in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

  Variations of the device described above may have applicability in normal endoscopes and open surgical instruments, and applicability in robot-assisted surgery. For example, those skilled in the art will recognize that the various teachings herein are published August 31, 2004, entitled “Robotic Surgical Tool with Ultrasounding and Cutting Instrument”, the disclosure of which is incorporated herein by reference. It will be appreciated that it can be readily combined with the various teachings of US Pat. No. 6,783,524.

  The aforementioned variants can be designed to be disposed of after a single use, or their forms can be designed to be used multiple times. The features can be readjusted for reuse in any case after at least one use. Reconditioning may include any combination of the steps of disassembling the device, followed by cleaning and replacement of particular parts, and subsequent reassembly. In particular, some variations of the device may be disassembled, and any number of particular pieces or parts of the device may be selectively replaced or removed in any combination. . Upon cleaning and / or replacement of particular parts, several variations of the device may be reassembled for subsequent use either at a reconditioning facility or by the user immediately prior to the surgical procedure. Those skilled in the art will appreciate that device reconditioning can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of this application.

  By way of example only, the forms described herein may be sterilized before and / or after surgery. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a radiation field that can penetrate the container, such as gamma radiation, x-rays, or high energy electrons. Radiation can kill bacteria on the device and in the container. The sterilized device may then be stored in a sterilized container for later use. The device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or water vapor.

  While various forms of the disclosure have been illustrated and described, further modifications to the methods and systems described herein can be accomplished by appropriate modifications by those skilled in the art without departing from the scope of the invention. While some of such possible modifications have been described, other modifications will be apparent to those skilled in the art. For example, the examples, forms, geometric figures, materials, dimensions, ratios, processes, etc. discussed above are exemplary and not essential. Accordingly, the scope of the present invention should be considered from the following claims, and should not be construed to be limited to the details of construction and operation shown and described herein and in the drawings.

Embodiment
(1) a surgical instrument,
(A) a handle assembly,
i. Trigger,
ii. A housing having a distal opening formed in a distal end of the housing; and iv. A drive assembly including a drive member in communication with the trigger such that actuation of the trigger is configured to actuate the drive member in a first direction;
(B) a transmission assembly,
i. Proximal shaft,
ii. A rotator knob, the rotator knob having a proximal portion, the proximal portion having a coupling mechanism;
iii. A distal shaft assembly extending distally with respect to the rotator knob; and iv. A transmission assembly including an end effector coupled to a distal end of the distal shaft assembly;
The surgical instrument, wherein the drive member of the handle assembly is removably coupled to the proximal shaft portion of the transmission assembly.
(2) The coupling mechanism of the proximal portion of the rotator knob includes a shelf that defines a portion of the distal opening of the housing when the transmission assembly is removably coupled to the handle assembly. The surgical instrument of embodiment 1, comprising a tab configured to abut the portion.
(3) The surgical instrument according to embodiment 2, wherein the tab is elastically biased so as to contact the shelf.
(4) The surgical instrument according to embodiment 1, wherein the proximal shaft includes a spring disposed on the proximal shaft portion.
(5) When the drive member is removably coupled to the proximal shaft portion, the trigger moves the drive member distally from a first position to a second position, and the second position The surgical instrument of embodiment 4, wherein the surgical instrument is operable to compress the spring.

6. The surgical of embodiment 5, wherein the trigger is further operable to release the spring and return the drive member proximally to the first position upon release of a biasing force. Instruments.
The surgical instrument of claim 1, further comprising a spring disposed on the proximal shaft portion and a retaining ring configured to be disposed in a groove defined in the proximal shaft portion. .
8. The surgical instrument of embodiment 7, wherein the drive member includes a recessed groove defined in an interior wall that defines a recessed space.
(9) The surgical instrument according to embodiment 8, wherein the proximal shaft portion is configured to be received in the recessed space of the drive member.
(10) When the proximal shaft portion is received in the recessed space of the drive member, the retaining ring defines the recessed space until it is finally received in the recessed groove portion. The surgical instrument of embodiment 9, wherein the surgical instrument is configured to compress against the wall.

The surgical instrument of claim 1, wherein the proximal shaft portion includes a spring disposed on the proximal shaft portion and a resiliently biased clamping component.
12. The embodiment of embodiment 11 wherein the resiliently biased clamping component includes a retaining arm having an end wedge configured to be disposed in a groove defined in the drive member. The surgical instrument as described.
13. The surgical instrument of embodiment 12, wherein the end wedge is resiliently biased outward.
(14) When the rotator knob is moved proximally into the distal opening, the proximal portion of the rotator knob grips the retaining arm of the clamping component and The surgical instrument of embodiment 12, configured to compress the retaining arm inward until the end wedge is disposed in the groove of the drive member.
(15) The rotator is removable and is configured to be moved in a distal direction when the end wedge is disposed in the groove of the drive member, thereby The surgical instrument of embodiment 14, wherein the proximal portion releases the retaining arm of the clamp component and causes the retaining arm to return to a resiliently biased outer position.

(16) a surgical instrument,
(A) a handle assembly,
i. Trigger,
ii. A housing having a distal opening formed in a distal end of the housing;
iii. A drive member disposed within the housing, wherein the drive member is in communication with the trigger; and iv. A handle assembly including a biasing member;
(B) a transmission assembly,
i. Proximal shaft,
ii. A distal shaft assembly extending distally from the proximal shaft portion, wherein the distal shaft assembly includes an inner tube; and iii. A transmission assembly including an end effector coupled to a distal end of the distal shaft assembly;
The surgical instrument, wherein the drive member is configured to removably engage the proximal shaft portion of the transmission assembly via the biasing member.
(17) The biasing member includes a spring-mounted ball bearing disposed on a yoke communicating with the driving member and the trigger, and the spring-mounted ball bearing is a notch in the proximal shaft portion. Configured to be attached to
An isolation yoke surface is disposed within the yoke, the isolation yoke surface defining an opening, the opening being sized to receive a waveguide of the transmission assembly, the isolation yoke surface being The waveguide is disposed so as to be flush with the proximal end of the transmission assembly, from which the waveguide extends when the drive member engages the transmission assembly, whereby the isolation yoke surface is Embodiment 17. The surgical instrument of embodiment 16, wherein the surgical instrument provides a high distal pushing force and a corresponding low proximal traction force against the engaging transmission assembly.
(18) The proximal shaft portion includes a portion of the inner tube of the transmission assembly, the biasing member includes a ball bearing disposed on the drive member, the ball bearing corresponding to the inner tube. The surgical instrument of claim 16, wherein the surgical instrument is configured to be attached to a notch.
(19) a surgical instrument,
(A) a handle assembly,
i. Trigger,
ii. A housing having a distal opening formed in a distal end of said housing; and iii. A transducer assembly disposed within the housing, the transducer assembly including a transducer, the transducer having a distal end coupling mechanism that does not use screws, and a handle assembly; ,
(B) a shaft assembly,
i. Proximal shaft,
ii. A transmission assembly extending distally from the proximal shaft portion, the transmission assembly including a waveguide, the waveguide having a proximal end coupling mechanism that does not use a screw; and iii. . A shaft assembly including an end effector coupled to a distal end of the transmission assembly;
The non-screw proximal end coupling mechanism of the waveguide is received within the transducer's non-screw distal end coupling mechanism or the screw-free distal end coupling mechanism A surgical instrument configured to abut against.
(20) The distal end coupling mechanism and the proximal end coupling mechanism are each tapered, and the tapered proximal end coupling mechanism of the waveguide is the tapered distal end coupling of the transducer. Configured to be received within a mechanism, the surgical instrument further includes a slip cap disposed on the proximal shaft portion, the slip cap defining a wall defining the distal opening of the housing The surgical instrument of embodiment 19, wherein the surgical instrument is configured to engage the portion with a screw.

Claims (14)

A surgical instrument,
(A) a handle assembly,
i. Trigger,
ii. A housing having a distal opening formed in a distal end of the housing; and ii . A drive assembly including a drive member in communication with the trigger such that actuation of the trigger is configured to actuate the drive member in a first direction;
(B) a transmission assembly,
i. Proximal shaft,
ii. A rotator knob, the rotator knob has a proximal portion and a distal portion, the proximal portion will have a coupling mechanism, wherein the distal portion, the said rotator knob than the proximal portion A rotator knob having a knob portion expanded outwardly about the longitudinal axis of the
iii. A distal shaft portion extending distally with respect to the rotator knob; and iv. A transmission assembly including an end effector coupled to a distal end of the distal shaft portion ;
The drive member of the handle assembly is removably coupled to the proximal shaft portion of the transmission assembly ;
The coupling mechanism of the proximal portion of the rotator knob contacts a shelf that defines a portion of the distal opening of the housing when the transmission assembly is removably coupled to the handle assembly. A resilient arm having a tab configured to contact ,
The surgical instrument, wherein the resilient arm extends from the knob portion. The surgical instrument of claim 1 , wherein the tab is resiliently biased to abut against the shelf. The proximal shaft section comprising said proximal spring disposed on the shaft portion, surgical instrument according to claim 1. When said driving member is removably coupled to said proximal shaft portion, the trigger, the moving distally with the driving member from the first position to the second position, so as to compress the pre-Symbol spring The surgical instrument of claim 3 , wherein the surgical instrument is operable. The surgical instrument according to claim 4 , wherein the trigger is further operable to release the spring and return the drive member proximally to the first position upon release of a biasing force.   The surgical instrument of claim 1, further comprising a spring disposed on the proximal shaft portion and a retaining ring configured to be disposed in a groove defined in the proximal shaft portion. The surgical instrument according to claim 6 , wherein the drive member includes a recessed groove defined in an interior wall defining a recessed space. The surgical instrument according to claim 7 , wherein the proximal shaft portion is configured to be received within the recessed space of the drive member. When the proximal shaft portion is received in the recessed space of the drive member, the retaining ring is in the inner wall defining the recessed space until finally received in the recessed groove. The surgical instrument of claim 8 , wherein the surgical instrument is configured to compress against.   The surgical instrument of claim 1, wherein the proximal shaft portion includes a spring disposed on the proximal shaft portion and a resiliently biased clamping component. The surgical of claim 10 , wherein the resiliently biased clamping component includes a retention arm having an end wedge configured to be disposed in a groove defined in the drive member. Appliances. The surgical instrument according to claim 11 , wherein the end wedge is resiliently biased outward. When the rotator knob is moved proximally into the distal opening, the proximal portion of the rotator knob grips the retaining arm of the clamping component and the end of the retaining arm. The surgical instrument according to claim 11 , wherein the surgical instrument is configured to compress the retaining arm inward until a wedge is disposed in the groove of the drive member. The rotator knob is removable and is configured to be moved in a distal direction when the end wedge is disposed in the groove of the drive member, whereby the rotator knob of the rotator knob The surgical instrument according to claim 13 , wherein a proximal portion releases the retaining arm of the clamping component and causes the retaining arm to return to a resiliently biased outer position.

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